G-CSF动员供者外周血单个核细胞输注治疗异基因造血干细胞移植后复发白血病的临床研究  

Research on the therapeutic effect of peripheral blood mononuclear cells infusion from donors stimulated with granulocyte colony-stimulating factor in the treatment of patient with relapsed leukemia after allogeneic hematopoietic stem cell transplantation

作　　者：刘嘉[1] 高力[1] 陈幸华[1] 刘耀[1] 高蕾[1] 曾韫璟[1] 张诚[1] 张曦[1] 

机构地区：[1]第三军医大学新桥医院血液科/重庆市医学重点学科,重庆400037

出　　处：《国际检验医学杂志》2011年第11期1151-1153,共3页International Journal of Laboratory Medicine

基　　金：国家自然科学基金资助项目(81070388);重庆市自然科学基金重点资助项目(2009BA5056);第三军医大学临床科研基金资助项目(2010D249)

摘　　要：目的 观察重组人粒细胞集落刺激因子（G-CSF）动员的供者外周血单个核细胞输注治疗异基因造血干细胞移植后,白血病复发的有效性及安全性.方法 对2009年7月至2011年2月该科20例异基因造血干细胞移植后复发的白血病患者,予以输注G-CSF动员后供者外周血单个核细胞.其中5例急性淋巴细胞白血病-CR2,8例急性髓系白血病-CR2,2例急性髓系白血病-CR3,3例急性混合细胞白血病,2例加速期慢性髓系白血病.在异基因造血干细胞移植后,半年内,20例患者均复发,予G-CSF动员后,供者外周血单个核细胞输注,每次输注细胞量按1×105/kg、2×105/kg、4×105/kg逐级增加,每次输注间隔4周.结果 12例患者再次完全缓解,8例患者未缓解.输注后,3例患者发生了Ⅰ～Ⅱ度急性移植物抗宿主病,12例患者发生了慢性移植物抗宿主病,5例未发生并发症,未观察到输注相关的全血细胞减少.结论 G-CSF动员供者外周血单个核细胞输注治疗异基因造血干细胞移植后,白血病复发有较好的疗效,不良反应小,值得临床进一步推广.Objective To investigate the efficacy and safety of growth factor-primed donor hematopoietic stem cells infusion （GPBSCI）from donors stimulated with granulocyte colony-stimulating factor（G-CSF） in the treatment of patients with relapsed leukemia after allogeneic hematopoietic stem cell transplantation（allo-HSCT）. Methods 20 cases of patients with relapsed leukemia,occurring in six months after allo-HSCT, among whom 5 cases were acute lymphoblastic leukemia（ALL） in CR2,8 were acute myeloid leukemia（AML） in CR2,2 were AML in CR3,3 were acute mixed lineage leukemia（MAL） and 2 were chronic myeloid leukemia at accelerated phase, received GPBSCI,during Jul. 2009 to Feb. 2011. The dose of cells infusion was 1 × 10^5/kg for the first time,2× 10^5/kg for the second time,4× 10^5/kg for the third time and so on,and the cells infusion was performed once for every four weeks. Results After receiving GPBSCI,12 patients received complete remission again,3 patients developed grade Ⅰ -- Ⅱ a cute GVHD, 12 patients developed chronic GVHD,5 patients had not any complication and no transfusion related pancytopenia was observed in all patients. Conclusion This research could suggest that GPBSCI might be an effective method for the treatment of patients with relapsed leukemia after allo-HSCT,which deserves further study and extended clinical application.

关 键 词：造血干细胞移植 白血病 复发 G-CSF动员的供者外周血单个核细胞 

分 类 号：R733.7[医药卫生—肿瘤]